Individual
MRS. KELLY SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MACCCSLP
Contact information
Practice address
4928 CINDERWOOD DR, YUKON, OK 73099-2118
(405) 350-2654
Mailing address
4928 CINDERWOOD DR, YUKON, OK 73099-2118
(405) 350-2654
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2975
OK
Other
Enumeration date
04/25/2007
Last updated
07/08/2007
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